June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
1 year-Real world clinical audit of aflibercept use in the management of macular edema secondary to central retinal vein occlusion at Moorfields Eye Hospital
Author Affiliations & Notes
  • Eleni Vrizidou
    Medical Retina, Moorfields Eye Hospital, LONDON, United Kingdom
  • Maria Eleftheriadou
    Medical Retina, Moorfields Eye Hospital, LONDON, United Kingdom
  • Fani Zacharaki
    Medical Retina, Moorfields Eye Hospital, LONDON, United Kingdom
  • Peter Addison
    Medical Retina, Moorfields Eye Hospital, LONDON, United Kingdom
  • Footnotes
    Commercial Relationships   Eleni Vrizidou, None; Maria Eleftheriadou, None; Fani Zacharaki, None; Peter Addison, Allergan (F), Allimen (S), Bayer (F), Bayer (S), Novartis (F), Novartis (S)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1554. doi:
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      Eleni Vrizidou, Maria Eleftheriadou, Fani Zacharaki, Peter Addison; 1 year-Real world clinical audit of aflibercept use in the management of macular edema secondary to central retinal vein occlusion at Moorfields Eye Hospital. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1554.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Landmark multi-center studies (COPERNICUS,GALILEO) have demonstrated the efficacy of aflibercept use for macular edema (ME) secondary to central retinal vein occlusion (CRVO)
This retrospective, observational clinical study examines aflibercept treatment outcomes in a tertiary center CRVO injection service for comparison to idealized outcomes

Methods : Aflibercept was used as the first-line intravitreal agent for ME secondary to CRVO at monthly intervals until maximum visual acuity and OCT parameters were noted.All patients who started treatment within 6 months of 1/06/15 and who had not received alternate treatment for ME within the prior 3 months were included

Results : 29 eyes of 28 patients are included.9 eyes (31%) were ischemic (>10 disc areas of angiographic non-perfusion).9 eyes (31%) had macula ischemia, 5 of these 9 eyes(55.5%) had peripheral ischemia too. Overall, 44.8% gained 15 or more letters, including 6 of 9 eyes(66.7%) with macula ischemia.Mean vision gain was 12 letters(range:-5 to +31; standard deviation [SD]:10).Initial vision in the non-ischemic group was 52 letters (range: 10-85; SD: 19) and 23 letters in the ischemic group (range: 0-64; SD:24; p<0.005), however both groups gained an average of 13 letters with treatment.Average decrease in CRT was 275um (range:-176-860; SD:231). 37.9% achieved dry OCT with treatment.No patients developed neovascularization at the anterior or posterior segment
Sub-group analysis of treatment naïve patients(14 letter gain [SD:10];CRT reduction 290 [SD: 246]) did not show a significant difference in mean visual improvement or CRT reduction when compared to previously treated patients (9.2 letter gain [SD:11] CRT reduction 251 [SD:215], p=0.66)

Conclusions : In this study visual and anatomic parameters were improved significantly, but not to the same degree as in idealised clinical trials.Interestingly, ischemic group demonstrated a significant and meaningful improvement in vision, and should not preclude a trial of treatment in clinical practice.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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